National trends in postpartum readmission risk for venous thromboembolism

Background Venous thromboembolism (VTE) is a common vascular complication of noncardiac surgery. Methods We evaluated national trends in perioperative in-hospital VTE incidence, management, and outcomes using a large database of hospital admissions from the United States. Patients aged ≥ 45 years undergoing major noncardiac surgery from 2005 to 2013 were identified from the National Inpatient Sample. In-hospital perioperative VTE was defined as lower extremity deep vein thrombosis (DVT) or pulmonary embolism (PE), and the incidence was evaluated over time. Multivariable regression models with demographics and comorbidities as covariates were generated to estimate adjusted odds ratios (aOR). Results Major noncardiac surgery was performed in 9,431,442 hospitalizations that met inclusion criteria, and perioperative VTE occurred in 99,776 patients (1,057 per 100,000), corresponding to an annual incidence of ≈53,000 after applying sample weights. Over time, perioperative VTE per 100,000 surgeries increased by 135 (95% confidence interval [CI]: 107–163), from 925 in 2005 to 1,060 in 2013 (p for trend <0.001; aOR [for 2013 vs. 2005]: 1.22, 95% CI: 1.19–1.26), due to increases in nonfatal VTE rates (from 840 [per 100,000 surgeries] in 2005 to 987 in 2013; p for trend <0.001). Perioperative VTE occurred most frequently in patients undergoing thoracic (2.0%) and vascular surgery (1.8%). Mortality was higher in patients with VTE than those without VTE (aOR: 3.12, 95% CI: 3.05–3.20). Conclusion Perioperative VTE occurs in approximately 1% of patients ≥45 years undergoing major noncardiac surgery, with increasing incidence of nonfatal VTE over time.

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National Trends in Hospitalizations for Venous Thromboembolism

Journal of Vascular Surgery ◽

10.1016/j.jvs.2016.07.077 ◽

2016 ◽

Vol 64 (4) ◽

pp. 1177-1178

Author(s):

Anand Brahmandam ◽

Marwan S. Abougergi ◽

Cassius Iyad Ochoa Chaar

Keyword(s):

Venous Thromboembolism ◽

National Trends

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Data Watch: Fatality at 28 Days After First Venous Thromboembolism

Internal Medicine News ◽

10.1016/s1097-8690(06)74562-0 ◽

2006 ◽

Vol 39 (23) ◽

pp. 2

Keyword(s):

Venous Thromboembolism

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For Venous Thromboembolism, Prophylaxis Falls Short Worldwide

Hospitalist News ◽

10.1016/s1875-9122(08)70017-8 ◽

2008 ◽

Vol 1 (1) ◽

pp. 10

Author(s):

NANCY WALSH

Keyword(s):

Venous Thromboembolism ◽

Thromboembolism Prophylaxis ◽

Venous Thromboembolism Prophylaxis

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Superiority of Fondaparinux Over Enoxaparin in Preventing Venous Thromboembolism in Major Orthopedic Surgery Using Different Efficacy End Points

Yearbook of Pulmonary Disease ◽

10.1016/s8756-3452(08)70118-x ◽

2006 ◽

Vol 2006 ◽

pp. 148-151

Author(s):

K.L. Lewis

Keyword(s):

Venous Thromboembolism ◽

Orthopedic Surgery ◽

End Points ◽

Major Orthopedic Surgery

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Statins for prevention of venous thromboembolism – are we facing an indication extension soon?

VASA ◽

10.1024/0301-1526/a000781 ◽

2019 ◽

Vol 48 (3) ◽

pp. 281-282

Author(s):

Julia Illner

Keyword(s):

Venous Thromboembolism

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German S3 guideline for the prevention of venous thromboembolism updated Comment on Vasa Supplement 92

VASA ◽

10.1024/0301-1526/a000559 ◽

2016 ◽

Vol 45 (5) ◽

pp. 347-348 ◽

Cited By ~ 4

Author(s):

Sylvia Haas ◽

Albrecht Encke ◽

Ina Kopp

Keyword(s):

Venous Thromboembolism ◽

S3 Guideline

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Venous thromboembolism in a general hospital. An update with low molecular weight heparin prophylaxis

VASA ◽

10.1024/0301-1526.36.1.17 ◽

2007 ◽

Vol 36 (1) ◽

pp. 17-22

Author(s):

Schulz ◽

Kesselring ◽

Seeberger ◽

Andresen

Keyword(s):

Molecular Weight ◽

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Low Molecular Weight ◽

Trauma Patients ◽

Vte Prophylaxis ◽

Vein Thrombosis ◽

Patients At Risk ◽

Hospital Stays ◽

Event Rates

Background: Patients admitted to hospital for surgery or acute medical illnesses have a high risk for venous thromboembolism (VTE). Today’s widespread use of low molecular weight heparins (LMWH) for VTE prophylaxis is supposed to have reduced VTE rates substantially. However, data concerning the overall effectiveness of LMWH prophylaxis is sparse. Patients and methods: We prospectively studied all patients with symptomatic and objectively confirmed VTE seen in our hospital over a three year period. Event rates in different wards were analysed and compared. VTE prophylaxis with Enoxaparin was given to all patients at risk during their hospital stay. Results: A total of 50 464 inpatients were treated during the study period. 461 examinations were carried out for symptoms suggestive of VTE and yielded 89 positive results in 85 patients. Seventy eight patients were found to have deep vein thrombosis, 7 had pulmonary embolism, and 4 had both deep venous thrombosis and pulmonary embolism. The overall in hospital VTE event rate was 0.17%. The rate decreased during the study period from 0.22 in year one to 0,16 in year two and 0.13 % in year three. It ranged highest in neurologic and trauma patients (0.32%) and lowest (0.08%) in gynecology-obstetrics. Conclusions: With a simple and strictly applied regimen of prophylaxis with LMWH the overall rate of symptomatic VTE was very low in our hospitalized patients. Beside LMWH prophylaxis, shortening hospital stays and substantial improvements in surgical and anasthesia techniques achieved during the last decades probably play an essential role in decreasing VTE rates.

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Risk of venous thromboembolism following surgical treatment of superficial venous incompetence

VASA ◽

10.1024/0301-1526/a000656 ◽

2017 ◽

Vol 46 (6) ◽

pp. 484-489 ◽

Cited By ~ 7

Author(s):

Tom Barker ◽

Felicity Evison ◽

Ruth Benson ◽

Alok Tiwari

Keyword(s):

Venous Thromboembolism ◽

Varicose Vein ◽

Lower Incidence ◽

Varicose Veins ◽

Secondary Data ◽

Foam Sclerotherapy ◽

Increased Risk ◽

Significant Difference ◽

Chi Squared ◽

One Year

Abstract. Background: The invasive management of varicose veins has a known risk of post-operative deep venous thrombosis and subsequent pulmonary embolism. The aim of this study was to evaluate absolute and relative risk of venous thromboembolism (VTE) following commonly used varicose vein procedures. Patients and methods: A retrospective analysis of secondary data using Hospital Episode Statistics database was performed for all varicose vein procedures performed between 2003 and 2013 and all readmissions for VTE in the same patients within 30 days, 90 days, and one year. Comparison of the incidence of VTEs between procedures was performed using a Pearson’s Chi-squared test. Results: In total, 261,169 varicose vein procedures were performed during the period studied. There were 686 VTEs recorded at 30 days (0.26 % incidence), 884 at 90 days (0.34 % incidence), and 1,246 at one year (0.48 % incidence). The VTE incidence for different procedures was between 0.15–0.35 % at 30 days, 0.26–0.50 % at 90 days, and 0.46–0.58 % at one year. At 30 days there was a significantly lower incidence of VTEs for foam sclerotherapy compared to other procedures (p = 0.01). There was no difference in VTE incidence between procedures at 90 days (p = 0.13) or one year (p = 0.16). Conclusions: Patients undergoing varicose vein procedures have a small but appreciable increased risk of VTE compared to the general population, with the effect persisting at one year. Foam sclerotherapy had a lower incidence of VTE compared to other procedures at 30 days, but this effect did not persist at 90 days or at one year. There was no other significant difference in the incidence of VTE between open, endovenous, and foam sclerotherapy treatments.

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